Death Investigation in the US – Medical Examiner or Coroner?

It’s common, in cases which involve a death, for the determination, by autopsy, of manner and cause of that death to result in criminal charges being filed against a suspect.  And in many cases, the results of that autopsy will be the evidence that convicts or acquits that suspect.  Unfortunately, it’s all too common for the results of an autopsy to be unreliable or downright wrong.

A wrong result from an autopsy?  How can this happen?  Accurate determination of manner and cause of death by autopsy requires a medical examiner, or coroner, with a high level of competency and with special training.  Sadly, there are both coroners and forensic pathologists practicing in this country who are unfit for the job.  To understand how this can be, it’s important to understand the distinction between a “medical examiner” and a “coroner.”  Medical examiners are appointed, or hired, by the responsible governmental body, and are uniformly qualified as forensic pathologists.  Coroners are politically elected, and in some states, are not even required to be a doctor.  In fact, South Carolina only recently required that a coroner be a high school graduate.  Coroners who have no medical credentials what so ever will commonly hire or contract forensic pathologists to perform the actual autopsies, but the competence and credentials of those pathologists may be of little concern to the hiring coroner, and the most important determining factor controlling those hiring decisions will be the budget.  There is also evidence to suggest that because the coroner is an elected political position, that those officials may unduly favor law enforcement in the decisions that they make.

The problems with the coroner system have been egregious enough that the National Academy of Sciences, in it’s landmark 2009 report “Strengthening Forensic Science in the United States, A Path Forward,” recommended that the coroner system be abolished.

In February, 2011, PBS aired an hour long investigation into the coroner system in the US titled ‘Post Mortem.’  I personally found this to be illuminating, eye-opening, infuriating, and riveting.  You can watch the video, PBS Frontline, “Post Mortem” here.